IT Band and Runners Knee

This post is a follow up to my earlier post on runners knee.

A common explanation or cause for runners knee is often said to be tightness in the iliotibial band (IT band).  It is believed that the kneecap can get pulled from its optimal position leading to tracking problems.

The IT band is a dense tendon like connective tissue attachment running from the side of the knee all the way to the hip. It is actually a support structure and should be tight, but this tightness can invariably lead to problems associated with the knee and hip. If the IT band is under high tension it can pull on the outside of the knee where it attaches. If this tension on the knee is too much it might lead to a constant pull on the patella as it moves with the femur. This could possibly lead to irritation and dysfunction of runners knee.

Are tight IT bands associated with runners knee?

Without boring you with all the studies (if you require links or references to this material please pm me) there is no solid evidence to suggest that that IT band tightness leads to runners knee. Studies suggest that those who have been diagnosed with runners knee and IT band syndrome, very few actually have tight IT bands.  Yet tight IT bands continuously gets the nod as a leading cause of runners knee. Surely if they have tight IT bands they should also be diagnosed with IT band syndrome. To be honest it’s seems quite a mess of evidence and information when trying to diagnose the real cause of knee pain especially conditions such as IT band syndrome and runners knee.  According to the evidence it seems highly unlikely that a tight IT band is a factor in patellofemoral pain syndrome/runners knee.

How do I treat runners knee or IT band syndrome?

I tend to stay away from diagnosing or ‘labelling’ any form of pain. Instead I try to look at the bigger picture. Everybody is different and exhibits a different range of symptoms. A compete analysis of someones posture, pelvis, range of motion, flexibility, daily habits and hobbies needs to be examined. I think certain therapists rely way too much on ‘scientific evidence’ for validating treatment and do not put enough empahasis on hands-on assessments and treating what they find.

Whenever somebody makes an appointment with me with suspected runners knee I rely mostly on my hands for finding areas of tension or imbalances within muscle groups. Way too much attention is given to individual muscles and not the entire connective chain. For example the IT band blends into the lateral quadricpes, lateral hamstrings and tighter hip muscles.  You couldn’t find more tension anywhere else if you looked for it. Overuse is often overlooked and very often the cause of nagging sports injuries. For me there is only form of hands on therapy to relieve overuse injuries – gentle modern myofascial release.

The connective tissue needs to be treated to allow the muscles to function they way they should. I do believe in quality homecare exercise with the use of foam rolling, acupressure balls, heat and proper stretching. You must complement the work of your therapist in order to make a speedy, full recovery and continue the homecare in order to prevent a re-occurence. Currently all the buzz is around injury prevention. If you’re a keen athlete one form of injury prevention is yoga. It is fast becoming more and more popular with dedicated courses for runners, individual classes, male only classes. A great idea for a whole body workout of the connective chain!

If you have any queries on any of the above please contact me on


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